News Post From Kaigie Staff

Coronavirus Vaccine Update
Kaigie Staff- 
From my cousin, Dr. Robert Colton

CORONAVIRUS VACCINES ARE COMING!
Coronavirus is probably “ending”
Don’t die before the summer
How do they work, will it eliminate Covid-19, what is the long-term outlook, when can you get one, which one should you get ?
1. HOW DO THEY WORK (read if you like science)
The first 2 vaccines from Pfizer and Moderna, are using a novel (brand new) technology based on Messenger RNA- it’s absolute genius. The virus pierces our cells using what is called a spike protein. Scientists quickly determined the amino acid sequence of the spike protein. Then they reverse engineered the mRNA that manufactures the spike protein. The mRNA is encapsulated in a nanoparticle lipid shell to allow the mRNA to traverse the cell membrane. Inside the cell, the mRNA combines with cell structures called ribosomes to form micro 3-D printers and “print” thousands of copies of the spike protein. This spike protein being “foreign”, induces the production of neutralizing antibodies that attack the spike protein rendering the virus incapable of getting into our cells and replicating. Voila! No form of the virus ever enters our body so we cannot get Coronavirus from the vaccines. And the mRNA breaks down over time, leaving no permanent genetic footprint.
Nobody knew if this new, fast way of making a vaccine would work. But it did! Both vaccines, using similar technology reduced symptomatic infections by 90 to 95% compared to control groups
All the vaccines that are in phase 3 have shown good production of neutralizing antibodies.
To better understand the difference among the vaccines, watch this video that simplifies the science:
https://www.youtube.com/watch?v=KMc3vL_MIeo...
2. WHAT IS THE LONG -TERM OUTLOOK?
Many have focused on the duration of antibody response. People who have had a prior Covid-19 infection have cellular or T-cell immunity. Re-infection has occurred but is exceedingly rare. The vaccines however, do not induce cellular immunity. Without measurable antibodies, we have what is called immunologic memory. Dedicated plasma cells (antibody producing cells) remember a prior infection and rapidly ramp up antibody production when re-exposed. We may be recommending coronavirus vaccine booster, but absent a mutation of the virus, we will probably be fine.
Potential mutation is a bigger problem. Viruses can mutate and remain infectious. HIV-AIDS viruses mutate frequently and are still pathogenic, Flu viruses less so. Polio, smallpox, measles, not at all. Could the spike protein mutate to a form that can still pierce the cell AND be resistant to the polyclonal antibodies we manufacture to combat it? It’s possible.
If there is another coronavirus outbreak in the future, scientists can determine if the spike protein has mutated and in short order manufacture the corresponding vaccine- nip the infection in the bud.
Also, to prevent another uncontrolled epidemic, we need to be more like Taiwan and South Korea. Because of their previous experiences with SARS, a strong public health sector, and a cooperative citizenry, they were able to quash the Coronavirus without a vaccine: through testing, contact tracing, masking, and quarantining.
We cannot afford another catastrophe.
3. WHEN WILL YOU BE ABLE GET A VACCINE?
Coronavirus vaccines most likely will receive emergency use authorization (EUA) from the FDA within weeks. Pfizer already applied for the EUA, could get approval as early as December 10th, and begin immunizing on December 12th. Moderna is closely behind by about 2 weeks.  There are about 20 million Pfizer doses ready for administration before the end of the year. Manufacturers can ramp up production so that everyone in the US can receive vaccinations by the end of May 2021. Moderna and Pfizer vaccines require 2 doses, 3 or 4 weeks apart.
The CDC will distribute all the vaccines to state and local governments and administer to the public at local pharmacies and other venues, possibly doctor’s offices.  They will be free.
The Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts, will help the CDC decide who will get the vaccines first and in what order. They have not made final recommendations yet, but it is likely the following will take precedence-
https://www.cdc.gov/.../vacc.../recommendations-process.html
Healthcare personnel- approximately 21 million people nationwide
Workers in essential and critical industries
People at high risk for severe COVID-19 illness due to underlying medical conditions
People 65 years and older
See timetable for vaccines below
How about children? Serious Coronavirus infection in children is rare. The main reason to vaccinate children is to help achieve herd immunity, i.e. prevent them from transmitting the virus to their parents, teachers, grandparents. Teenagers will be vaccinated first. Small studies to determine safety in younger children still need to be done, and then vaccinations can commence, likely this summer.
4. WILL THE VACCINES ELIMINATE COVID AND WHEN?
I read recently that vaccines won’t cure Covid-19, but vaccinations will. The 2 current vaccines were 95% more effective than placebo in preventing symptomatic infections. To become “immune”, you must generate an antibody response. Younger and healthier people will mount a brisk response to the vaccine. A recent study in a small group of individuals over 70, showed the antibody levels were equivalent to younger people. How about those even older, or immunosuppressed? We do not know.
You need 2 shots 3 or 4 weeks apart. 3 weeks after the second shot you should achieve an adequate immunity.
In order for vaccinations to eliminate Covid-19, it boils down to herd immunity and R0 once again. If 75% or more of Americans are immune through infection or vaccination, the R0 will drop way below 1.0 , and the disease will rapidly “die” out over a few months. An occasional person will still contract the disease, but it will not spread widely.
Can we get to 75%? That is the big question.
According to polls, only about 60% of Americans would readily take the vaccine now.
One reticent group are the right wing Anti-Vaxxers. Most are Trump supporters. Trump and the Republicans leaders have counted on the vaccine to cure Covid-19 since March. They have rightfully touted Operation Warp Speed as a major success of the current administration. If Trump, his family, Fox News, Newsmax, OAN, Rush Limbaugh, and others strongly reject the anti-vaccine conspiracies and publicly push the benefits of the vaccine, most of his followers should comply.
Another hesitant group is African Americans. https://www.washingtonpost.com/.../health-care-system.../... 
Again, I believe the leaders of their community could persuade their constituents to do what is in their best interest by getting vaccinated.
Lastly, schools, hospitals, many businesses, and others, will probably make vaccination mandatory as a condition of employment. Airlines, hotels, cruises might require evidence of immunity. Will this hold up in court? Probably.
There will always be a paranoid group of conspiracists who believe Bill Gates has imbedded a tracking microchip in the vaccines, but I believe that is a vocal but tiny minority.
I am optimistic. If everyone works together, especially our divided government, we will “cure” the epidemic by this summer
5. WHAT SHOULD YOU DO RIGHT NOW?
In the first 2 months after receiving the vaccinations, none of the tens of thousands of study participants have had any serious side effects related to the vaccinations.  Will there be any late complications beyond the 2-month period of observation in the vaccine trials?  Most experts doubt this.
Could the antibody response have a negative effect by facilitating Covid-19 infections?  Again, most believe this would have already happened.
Now we have two remarkably safe and surprisingly effective vaccines. Is there a downside? You need 2 shots.  Many people get a transient 24-hour flu-like reaction including fever, headache, and body aches. This means you are mounting an immune response- It’s a good sign.
Some next generation vaccines may have fewer side effects. The antibody response could last longer.  To me these are potentially minor and insignificant advantages
If approved by the FDA, I plan on vaccinating myself, my family, and all my employees with either of these two vaccines as soon as I can and I recommend the same for everyone.
Robert Colton MD
Boca Raton ,Florida
 
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